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As COVID-19 spreads across the globe, crowdsourced digital technology harbours the potential to improve surveillance and epidemic control, primarily through increased information coverage, higher information speed, fast case tracking and improved proximity tracing. Targeting those aims, COVID-19-related smartphone and web-based health applications are continuously emerging, leading to a multitude of options, raising ethical and legal challenges and potentially overwhelming end users. Building on an existing trustworthiness checklist for digital health applications, we searched the literature and developed a framework to guide the assessment of smartphone and web-based applications that aim to contribute to controlling the current epidemic or mitigating its effects. It further integrates epidemiological subject knowledge and a legal analysis, outlining the mechanisms through which new applications can support the fight against COVID-19. The resulting framework includes 40 questions across 8 domains on “purpose”, “usability”, “information accuracy”, “organisational attributes / reputation”, “transparency”, “privacy” and “user control / self-determination”. All questions should be primarily answerable from publicly available data, as provided by application manufacturers. The framework aims to guide end users in choosing a transparent, safe and valuable application and suggests a set of information items that developers ideally make available to allow a balanced judgement and facilitate the trustworthiness of their products.

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BACKGROUND: The novel coronavirus disease 2019 (COVID-19) pandemic is an urgent public health crisis, with epidemiologic models predicting severe consequences, including high death rates, if the virus is permitted to run its course without any intervention or response. Contact tracing using smartphone technology is a powerful tool that may be employed to limit disease transmission during an epidemic or pandemic; yet, contact tracing apps present significant privacy concerns regarding the collection of personal data such as location. OBJECTIVE: The aim of this study is to develop an effective contact tracing smartphone app that respects user privacy by not collecting location information or other personal data. METHODS: We propose the use of an anonymized graph of interpersonal interactions to conduct a novel form of contact tracing and have developed a proof-of-concept smartphone app that implements this approach. Additionally, we developed a computer simulation model that demonstrates the impact of our proposal on epidemic or pandemic outbreak trajectories across multiple rates of adoption. RESULTS: Our proof-of-concept smartphone app allows users to create "checkpoints" for contact tracing, check their risk level based on their past interactions, and anonymously self-report a positive status to their peer network. Our simulation results suggest that higher adoption rates of such an app may result in a better controlled epidemic or pandemic outbreak. CONCLUSIONS: Our proposed smartphone-based contact tracing method presents a novel solution that preserves privacy while demonstrating the potential to suppress an epidemic or pandemic outbreak. This app could potentially be applied to the current COVID-19 pandemic as well as other epidemics or pandemics in the future to achieve a middle ground between drastic isolation measures and unmitigated disease spread.

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The Internet of Things (IoT) brings internet connectivity to everyday electronic devices (e.g. security cameras and smart TVs) to improve their functionality and efficiency. However, serious security and privacy concerns have been raised about the IoT which impact upon consumer trust and purchasing. Moreover, devices vary considerably in terms of the security they provide, and it is difficult for consumers to differentiate between more and less secure devices. One proposal to address this is for devices to carry a security label to help consumers navigate the market and know which devices to trust, and to encourage manufacturers to improve security. Using a discrete choice experiment, we estimate the potential impact of such labels on participant's purchase decision making, along with device functionality and price. With the exception of a label that implied weak security, participants were significantly more likely to select a device that carried a label than one that did not. While they were generally willing to pay the most for premium functionality, for two of the labels tested, they were prepared to pay the same for security and functionality. Qualitative responses suggested that participants would use a label to inform purchasing decisions, and that the labels did not generate a false sense of security. Our findings suggest that the use of a security label represents a policy option that could influence behaviour and that should be seriously considered.

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The objective of this study was to gain information from egg donors in South Africa (SA) which could be pertinent to policy development on egg donation. The study was conducted on egg donors in the database of a Cape Town-based egg donation agency who donated within a year preceding the study. 150 egg donors from the population of 226 participated in an online survey. The main results are: 95% of respondents experienced egg donation as being positive. However, 7% of respondents report not giving proper informed consent, and a similar percentage of respondents also report not knowing whether any medical risks actually materialised as sequelae to their donations. This is a cause for concern and should be investigated further. Regarding donor anonymity, which is currently the legal position in SA, 79% of respondents indicated that they would still have donated had they been legally required to release their identities. Accordingly, possible legal reform away from the current system of donor anonymity seems unlikely to significantly impact the supply of donated eggs. Regarding motivation, respondents report being primarily motivated by wanting to help infertile women. However, respondents believe that a fair and realistic amount of compensation would be about 60% higher than what is currently paid as the national standard fixed amount. This fixed-amount compensation system should be further investigated in terms of its legality, impact on donor profile, and its current amount.

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OBJECTIVE: To explore the role of clinical providers and mothers on young women's ability to have confidential, candid reproductive health conversations with their providers. METHODS: We conducted 14 focus groups with 48 women aged 15-28 years (n = 9), and 32 reproductive healthcare workers (n = 5). Focus groups were audio recorded and transcribed. Data were analyzed using inductive coding and thematic analyses. We examined findings through the lens of paternalism, a theory that illustrates adults' role in children's autonomy and wellbeing. RESULTS: Mothers have a substantial impact on young women's health values, knowledge, and empowerment. Young women reported bringing information from their mothers into patient-provider health discussions. Clinical best practices included intermingled components of office policies, state laws, and clinical guidelines, which supported health workers' actions to have confidential conversations. There were variations in how health workers engaged young women in a confidential conversation within the exam room. CONCLUSIONS: Both young women and health workers benefit from situations in which health workers firmly ask the parent to leave the exam room for a private conversation with the patient. Young women reported this improves their comfort in asking the questions they need to make the best decision for themselves. Clinic leadership needs to ensure that confidentiality surrounding young women's reproductive health is uniform throughout their practice and integrated into patient flow.

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In multi-party deep learning, multiple participants jointly train a deep learning model through a central server to achieve common objectives without sharing their private data. Recently, a significant amount of progress has been made toward the privacy issue of this emerging multi-party deep learning paradigm. In this paper, we mainly focus on two problems in multi-party deep learning. The first problem is that most of the existing works are incapable of defending simultaneously against the attacks of honest-but-curious participants and an honest-but-curious server without a manager trusted by all participants. To tackle this problem, we design a privacy-enhanced multi-party deep learning framework, which integrates differential privacy and homomorphic encryption to prevent potential privacy leakage to other participants and a central server without requiring a manager that all participants trust. The other problem is that existing frameworks consume high total privacy budget when applying differential privacy for preserving privacy, which leads to a high risk of privacy leakage. In order to alleviate this problem, we propose three strategies for dynamically allocating privacy budget at each epoch to further enhance privacy guarantees without compromising the model utility. Moreover, it provides participants with an intuitive handle to strike a balance between the privacy level and the training efficiency by choosing different strategies. Both analytical and experimental evaluations demonstrate the promising performance of our proposed framework.

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Objectives. To examine demand for abortion medications through an online telemedicine service in the United States.Methods. We examined requests from US residents to the online telemedicine abortion service Women on Web (WoW) between October 15, 2017, and August 15, 2018. We calculated the population-adjusted rate of requests by state and examined the demographics, clinical characteristics, and motivations of those seeking services, comparing those in states with hostile versus supportive abortion policy climates.Results. Over 10 months, WoW received 6022 requests from US residents; 76% from hostile states. Mississippi had the highest rate of requests (24.9 per 100 000 women of reproductive age). In both hostile and supportive states, a majority (60%) reported a combination of barriers to clinic access and preferences for self-management. Cost was the most common barrier (71% in hostile states; 63% in supportive states; P < .001). Privacy was the most common preference (49% in both hostile and supportive states; P = .66).Conclusions. Demand for self-managed medication abortion through online telemedicine is prevalent in the United States. There is a public health justification to make these abortions as safe, effective, and supported as possible.

Introduction: Long-Term Care workers responses to the manifestations of residents' sexual behavior are very varied, prevailing negative attitudes and practices. Moreover, their level of knowledge in this subject is quite limited. Objectives: To synthesize and analyse the available evidence regarding professionals' perceptions about the sexuality of institutionalized older people in Long-Term Care institutions. Method: A systematic search of articles published in English or Spanish exploring the perceptions of professionals about the sexuality of institutionalized older people was carried out until May 2017 in Medline, Scopus, Web of Science (WOS), Consejo Superior de Investigaciones Científicas (CSIC), CUIDEN, ProQuest, PsycINFO, and CINHAL. Results: Six studies met the inclusion criteria. Professionals' perceptions were grouped in the following categories: the influence of negative stereotypes, the pressure of professionals' reactions and interpretations, family interference, need for privacy, need for regulation of sexual expression and the management of sexuality in people with dementia, lesbian, gay or bisexual. Conclusion: There are a lack standard response and awareness and a knowledge gap of professionals in response to sexual situations in institutionalized older people. It is necessary to establish guidelines promoting a common approach in the institutions and a reduction of harmful practices

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Nowadays, location based service (LBS) is one of the most popular mobile apps and following with humongous of location data been produced. The publishing of location data can provide benefit for promoting the quality of service, optimizing the commercial environment as well as harmonizing the infrastructure construction. However, as location data may contain some sensitive or confidential information, the publishing may reveal privacy and bring hazards. So the published data had to be disposed to protect the privacy. In order to cope with this problem, a number of algorithms based on the strategy of k-anonymity were proposed, but this is not enough for the privacy protection, as the correlation between the sensitive region and the background knowledge can be used to infer the real location. Thus, consider about this condition, in this paper a Îµ-sensitive correlation privacy protection scheme is proposed, and provides correlation indistinguishable to the location data. In this scheme, entropy is first used to determine the location centroid of each cell to build up the voronoi diagram. Then the coordinate of the untreated location data that is located in the cell is transferred into the centroid vicinity. Accordingly, the sensitive correlation is destroyed by the coordinate of each published data. The process of transferring the location data is determined by metrics of Îµ-sensitive correlation privacy, and is rigorous in mathematical justification. At last, security analysis is proposed in this paper to verify the privacy ability of our proposed algorithm based on voronoi diagram and entropy, and then we utilize the comparative experiment to further affirm the advantage of this algorithm in the location data privacy protection as well as the availability of published data.

Objectives: to examine the intimate affective relationships of young university students on the undergraduate nursing course at a public university, from a gender perspective. Method: this qualitative study was based on life narrative as its theoretical and methodological framework. From May to September 2017, 30 nursing students underwent individual unscripted interviews. The project was approved by the research ethics committee. Results: the young university students' affective relationships were characterized by control, jealousy, and male domination. The young nursing students were exposed to experiencing various different manifestations of violence in their intimate affective relationships. They considered gender issues to be the main influence in the occurrence of violence. Conclusion: considering the role of universities and their importance in changing social realities and in quality of life, as well as in health education, there is an urgent need to take preventive action and to develop measures to promote healthy relationships among young university students.

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With the aging of the population and the upgrading of the consumption structure of national health demand in China, it has become a new trend for the public to actively seek health products and services on social networks. Based on the theory of reasoned behavior and the theory of expectancy confirmation, this study aims to analyze the cognitive factors and their effects on WeChat users' purchase intention in the process of health product consumption. Considering that safety is a key feature of health products that distinguishes them from other consumer products, the "satisfaction" concept in the expectancy confirmation model is replaced by "trust" in this study. Two hundred and two (202) valid samples were collected by a questionnaire survey to analyze their intentions to buy health products on WeChat. Theoretical models and corresponding research hypotheses were verified by structural equation modeling. The research results show that emotional price and emotional experience are positively correlated with trust and purchase intention. There is an obvious negative correlation between privacy invasion and trust. Expectation confirmation is positively associated with trust. Moreover, the intermediary test shows that trust has completely mediated between emotional price and purchase intention, and trust also has a full intermediary effect on expectation confirmation and purchase intention.

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PURPOSE: The objective of this paper is to focus on seniors' acceptance of the usage of connected healthcare technologies in their homes. The authors integrated into technology acceptance model (TAM) several latent variables such as social presence, trust and degree of intrusiveness perceived with the use of connected health technologies. DESIGN/METHODOLOGY/APPROACH: The authors distributed the survey by post to 605 seniors. The authors targeted elderly people using connected health technologies (assistive alarm, telecare, sensors, etc.) at home and/or receiving healthcare at home. The authors received 213 questionnaires back. As The authors had several latent variables, the authors used partial least squares (PLS), a variance-based structural equation modeling method. FINDINGS: The results show that the level of trust in these technologies impacts significantly the perception of usefulness and the degree of intrusiveness. In parallel, the degree of usefulness of these technologies impacts positively elderly people's intention to accept their usage. Finally, one can claim that the perception of the social presence with the use of these technologies impacts positively the degree of perceived usefulness, trust and intrusiveness. RESEARCH LIMITATIONS/IMPLICATIONS: The sample covers a population benefiting from similar connected health technologies. It was difficult to distinguish and interpret the added value of each technology separately. As more and more elderly people use or are least familiarizing themselves with a range of connected technologies it would be interesting to identify which sets of connected technologies contribute the most to a positive feeling of social presence. SOCIAL IMPLICATIONS: These results are particularly relevant to stakeholders in the health industry in their quest to improve their products/services. A better understanding of the relation that the elderly have with connected health technologies is an essential prerequisite to supporting the development of new solutions capable of meeting the specific needs of our seniors. ORIGINALITY/VALUE: The authors want to apply the TAM to connected health technologies designed for elderly people and the authors also want to extend it by integrating the social presence, trust and degree of intrusiveness variables to our research model.

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With the rapid development of the Internet of Things (IoT), it becomes challenging to ensure its security. Identity authentication and integrity verification can be achieved by secure hash functions and digital signature algorithms for IoT applications. In order to solve the issues of bandwidth limitation and computational efficiency of secure communication in IoT applications, an aggregate signature scheme based on multi- trapdoor hash function is proposed in this paper. Firstly, to prevent key exposition, based on the elliptic curve discrete logarithm problem (ECDLP), we constructed a double trapdoor hash function (DTH) and proved its reliability. Secondly, the multi-trapdoor hash function (MTH) based on DTH is presented. Finally, an MTH-based aggregate signature scheme (MTH-AS) with constant signature length is proposed. Based on the assumption of ECDLP, the proposed scheme is proven unforgeable against adaptive chosen message attacks with the Forking Lemma. Different from the most signature schemes with bilinear mapping, the proposed scheme has higher computational efficiency and shorter aggregate signature length. Moreover, it is independent of the number of signers. Security analysis and performance evaluation has revealed that the proposed scheme is an ideal solution for secure IoT applications with limited computing power, storage capacity, or limited bandwidth, such as wireless sensor networks, vehicular ad hoc networks, or healthcare sensor networks.

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